Proposed is a community based participatory research project (CBPR) and evaluation for improving influenza immunizations in high risk populations within disadvantaged minority communities. The Harlem Community and Academic Partnership (HCAP)'s Board includes residents, community based organizations, academic partners and the local health department who meet monthly to plan, conduct and review neighborhood assessments, interventions and evaluation activities; topic-specific issues are addressed through formation of Intervention Work Groups (IWGs). The HCAP Board noted especially low rates of influenza immunizations in Harlem and formed the VIVA (Venue Intensive Vaccine for Adults) IWG. This IWG has conducted separate pilots including a survey on barriers to immunization, development of culturally informed intervention materials, a pilot of "yellow jacket" outreach workers to engage and educate hard-to reach populations, and provision of immunizations at non-traditional sites. The goal of this proposal is to assemble these components to formally scale up and test the intervention for adults in the Harlem communities. To achieve these aims, the HCAP VIVA IWG will plan, organize and implement an intervention; our primary partner, Palladia Inc, provides outreach educators and a service network of over 120 CBOs to educate and mobilize the community for immunization as well as coordinate congregating persons with traditional and new non-traditional venues for immunizations; the local Visiting Nurse Service has agreed to provide nurses and influenza vaccines at the selected venues gratis. This program does not replace, but rather supplements existing vaccination programs in the city by adding more relevant education and new "non-traditional" venues. We expect that this program will increase rates of immunizations overall including the hard-to-reach populations. To evaluate this program, we will compare annual rates of immunization between Harlem and communities similar to Harlem in NYC, with data available by neighborhood through the NYC annual "Community Health Survey" (modified BRFSS from CDC) which includes 10,000 adult NYC residents. We will also conduct two cross sectional street intercept surveys (n=800) before and after each annual intervention program between harlem and comparison community residents. These data combined with yearly inventories of CBOs, will provide measures of barriers, intervention experiences and outcomes to broaden input for continuous program improvement. [unreadable] [unreadable] [unreadable]